Sprinkart Alois Martin, Marx Christian, Träber Frank, Block Wolfgang, Thomas Daniel, Schild Hans, Kukuk Guido Matthias, Mürtz Petra
Dept. of Radiology, University of Bonn, Germany.
Rofo. 2018 Aug;190(8):758-766. doi: 10.1055/a-0637-9980. Epub 2018 Jul 25.
To directly compare different methods proposed for enhanced conspicuity and discriminability of prostate cancer on diffusion-weighted imaging (DWI) and to compare the results to original DWI images and conventional apparent diffusion coefficient (ADC) maps.
Clinical routine prostate DWI datasets (b = 0, 50, 800 s/mm², acquired at a field strength of 3 T) of 104 consecutive patients with subsequent MR-guided prostate biopsy were included in this retrospective study. For each dataset exponential ADC maps (eADC), computed DWI images (cDWI), and additionally eADC maps for computed b-values of 2000 and 3000 s/mm² were generated (c_eADC). For each of 123 lesions, the contrast (CR) and contrast-to-noise ratio (CNR) were determined. Differences in the CR and CNR of malignant lesions (n = 83) between the different image types and group differences between benign (n = 40), low-risk (n = 53) and high-risk (n = 30) lesions were assessed by repeated measures ANOVA and one-way ANOVA with post-hoc tests. The ability to differentiate between benign and malignant and between low-risk and high-risk lesions was assessed by receiver operating characteristic (ROC) curve analyses.
The CR and CNR were higher for computed DWI and related c_eADC at b = 3000 s/mm² and 2000 s/mm² compared to original DWI, conventional ADC and standard eADC. For differentiation of benign and malignant lesions, conventional ADC and CR of conventional ADC were best suited. For discrimination of low-risk from high-risk lesions, the CR of c_eADC was best suited followed by the CR of cDWI.
Computed cDWI or related c_eADC maps at b-values between 2000 and 3000 s/mm2 were superior to the original DWI, conventional ADC and eADC in the detection of prostate cancer.
· Prostate cancer can appear inconspicuous on original DWI800 images. · Computed DWI images at b = 2000 - 3000 s/mm² improve lesion-to-normal-tissue contrast in prostate cancer. · Contrast in computed DWI is superior to ADC and eADC at b = 800 s/mm².
· Sprinkart AM, Marx C, Träber F et al. Evaluation of Exponential ADC (eADC) and Computed DWI (cDWI) for the Detection of Prostate Cancer. Fortschr Röntgenstr 2018; 190: 758 - 766.
直接比较为提高前列腺癌在扩散加权成像（DWI）上的可视性和可辨别性而提出的不同方法，并将结果与原始DWI图像和传统表观扩散系数（ADC）图进行比较。
本回顾性研究纳入了104例连续接受MR引导下前列腺穿刺活检患者的临床常规前列腺DWI数据集（b = 0、50、800 s/mm²，在3 T场强下采集）。对于每个数据集，生成指数ADC图（eADC）、计算DWI图像（cDWI），以及另外针对计算得到的b值为2000和3000 s/mm²的eADC图（c_eADC）。对于123个病灶中的每一个，确定其对比度（CR）和对比噪声比（CNR）。通过重复测量方差分析和事后检验的单因素方差分析评估不同图像类型之间恶性病灶（n = 83）的CR和CNR差异，以及良性（n = 40）、低风险（n = 53）和高风险（n = 30）病灶之间的组间差异。通过受试者工作特征（ROC）曲线分析评估区分良性与恶性以及低风险与高风险病灶的能力。
与原始DWI、传统ADC和标准eADC相比，在b = 3000 s/mm²和2000 s/mm²时，计算DWI及相关c_eADC的CR和CNR更高。对于区分良性和恶性病灶，传统ADC及其CR最为合适。对于区分低风险和高风险病灶，c_eADC的CR最为合适，其次是cDWI的CR。
在b值介于2000和3000 s/mm²之间时，计算得到的cDWI或相关c_eADC图在前列腺癌检测方面优于原始DWI、传统ADC和eADC。
· 前列腺癌在原始DWI800图像上可能不明显。· 在b = 2000 - 3000 s/mm²时计算得到的DWI图像可改善前列腺癌病灶与正常组织之间的对比度。· 在b = 800 s/mm²时，计算DWI的对比度优于ADC和eADC。
· Sprinkart AM, Marx C, Träber F等。指数ADC（eADC）和计算DWI（cDWI）在前列腺癌检测中的评估。Fortschr Röntgenstr 2018; 190: 758 - 766。
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